Friday, April 13, 2012

How to Point: Teaching my daughter how to use her index finger

 *at the end of this post, I recommend two apps that were very beneficial in teaching Ellie to point.  I am not being paid to write this post although it would be very awesome to receive some compensation such as a free iPad or something exciting and whatnot.  

Pointing?  Who Cares?:
Prior to having Ellie, I took for granted pointing.  I knew that in having Down syndrome, Ellie would have delays in both fine motor development and language development.  I mistakenly assumed that pointing would come naturally and that we would use sign language prior to spoken words.  Until Ellie, I never truly realized just how much pointing serves as a means of communication.  Isolation of the index finger, as seen in pointing, is so important in forming many of the signs when conversing in American Sign Language [ASL].  Consequentially, for the longest time, SCREAM was (and at times still is) the primary language spoken by Ellie.
Confusion & Frustration:
Up until Ellie could point, I would hold up two options of food.  She would bat at them.  Sometimes she was batting at the food item to “shove it away” while other times she was batting to indicated that was the food she actually wanted.  I had to be a mind reader in order to figure out which food she truly desired.  I failed about 50% of the time.  When she started pointing, a whole new world of communication opened up.  If she pointed at a specific food, I knew that was the one she wanted.  Instead of loud, high-pitched screaming to indicated she desires something, she could now point to a toy on a shelf for me to get it down for her.  She can now formulate more intricate signs as a direct result of index finger isolation.  
Therapeutic Strategies Implemented:
Ellie took a lot longer to point than most of her friends with and without Down syndrome.  To the great frustration of myself, our therapists, and Ellie, we tried a variety of activities to help her achieve this fine motor skill.  I decorated the bottom of an empty egg carton with glitter, stickers, and fabric to encourage her to put her fingers into the bottoms of those egg shells.  I created a pegboard using an old heavy-duty cardboard shoe box.  I invested in a series of Melissa & Doug puzzles with those little knobs on them in hopes of eliciting a pincer grasp (using just the index finger and thumb to grasp an object).  I also doled out raisins one at a time to help Ellie move from the raking hand motion to the pincer grasp.  In spite of all these activities, Ellie’s fine motor abilities were not progressing.  

Exasperated! The Next Step:
Feeling like we reached a dead end (and that I was a failure because after all, no matter how hard we try, we look at our beautiful little progeny as extensions of ourselves), I did what any parent would do. . . I talked to other parents and discovered that the iPad might help.  Now, I know that not everyone can afford an iPad, but there are available grants out there for kids with special needs.  We got an old, version 1, refurbished iPad.  Meaning, we bought one used at a ridiculously cheap rate.  

I thought, “This was it!” only to discovered that many of the toddler apps were too sensitive to touch.  Ellie could just bat at the screen and something would happen (ie the cow would moo, it would move to the next flashcard, etc).  This did not promote pointing at all.  
Many other apps had the opposite problem.  They were not sensitive enough.  I would have to practically beat on the screen with my own finger to get a response.  In fact, I believe I nearly broke my hand trying to get to the next animal/body part on those evil Fisher Price apps. 
After a lot of research, trial & error, and wasted $1.99s, I have 2 iPad apps that I would like to recommend.  Both apps are less than $2.99, they are entertaining to kids, and they are educational.  What more could a mama bear want?
iPad Rules:
Now before leaving your little destructive toddler with a highly breakable iPad, I have two things to tell you.  The first is rather obvious.
  1. Supervise your bambina.  I had Ellie sit on my lap in the beginning.  I was in charge of the iPad, not the super-charged Ellie Bear.  Now, I sit on the floor with her, but she can hold it on her own, after all, I have to be free to snap my usual 20 million pictures of the spoiled princess toddler.
  2. Invest in an Otterbox case.  I am serious here.  This case, while bulky, is amazing.  I even have one for my phone.  Ellie has, unfortunately, dropped the iPad.  More than once (remember what I said about supervision?  Oops).  In fact, it crashed onto the Endocrinologist’s office floor yesterday from the exam table.  Yes, that far and. . . it DID NOT BREAK!  
I suppose I should tell you there is actually a 3rd and perhaps the most important thing: 
Do not expect your child to just start pointing automatically because she has an iPad.  It is magical, but not miraculous.  I started with Ellie sitting in my lap and I would help form her hand into a point.  I would then, with her hand formed in pointer position, guide her finger to the screen.  After a while, I would just form her hand and she had to tap the screen herself.  Finally, I stopped forming her hand.  Her pointing now extends beyond the iPad into daily activities and into some signing.  Now, I should tell you that I got a bit lazy and I never finished the above procedure for her left hand.  Her right hand does the perfect point 90% of the time while her left hand is at 30%.  

Recommended Apps:
I bet you thought I was never going to get to this section!  
  1. Starfall ABCs.  This app is derived from their website which is a free website.  The app, however, costs a few, but very worthwhile bucks.  It shows all of the letters in the form of building blocks.  The child selects a letter and then the app goes through the upper case & lower case letter name and sound.  For instance, you have to tap on the “A” and is says “A, ah, apple” and moves on to alligator, astronaut, etc.  Because of this educational app, the Bear can now point and can also identify many of her letters.  

  1. Duck Duck Moose Apps.  This is actually a company that provides a series of musical, interactive apps for $1.99 each.  They offer “Wheels on the Bus”, “Old MacDonald”, and “Itsy Bitsy Spider”.  Ellie LOVES the “Old MacDonald” one.  On each page, Ellie has to tap on the animal to elicit the sound &/or and action.  The farmer, when tapped, dances.  The cow, moos and does flips.  Aside from pointing, the Duck Duck Moose Apps have some actions that require dragging the finger across the screen (yay, more fine motor exercises!) such as when opening the doors of the bus or moving the tractor across the screen. These apps also have the option of selecting a language such as English, Spanish, German, French, etc.  

Ellie and I are always looking for new and exciting apps.  Please leave a comment telling us what your child’s favorite iPad or iPhone app is!



  1. Great info on pointing, Anna! We don't have an iPad but have talked about getting one for Bailey to use (if Taylor doesn't hijack it full time :)). How old was Ellie when she started using it? Bailey is just 17 months right now - I don't have enough experience with iPads to know if that is way too young?

  2. Tell Taylor that he has to share! I bet Bailey would enjoy it right now. I think we got one when Ellie was around 20-22 months old. I have to hide it. We have a PEC so that she can request it, but I have to hide that too or she will be handing me the PEC of the iPad all the time!

  3. What great info! Just forwarded this to my hubby as we've been talking ipad for awhile. But I realize that all apps are not created equal just by letting Cora play on his phone. Thanks for the recommendations!

  4. Our Ds group is getting all of the kids iPads. I'm so excited. Kamdyn can point, but she likes to use her thumb. But if she sees us using our pointer, she will imitate. I'll have to check back in here after we get our iPad.

  5. Now that I've moved to Malaysia where pointing with the index finger is offensive, I've had to learn NOT to do it. Instead, you make a closed fist, like the ASL sign for the letter "A", and point with your thumb. The ASL sign for "T" is considered especially rude, but I don't know why.

    Despite all this, many of the ethnic Chinese use their middle finger to point. I couldn't concentrate on what the pediatrician was saying once because I kept focusing on her pointing at the meds chart with her middle finger extended.

    In some of the surrounding countries like Thailand, the polite way to point is with the whole hand. So, maybe Ellie's just been going Thai on you this whole time. : )

  6. Where did you get your iPad? This is silly of me, but I've just been uselessly lusting after a new one & hadn't looked at buying used. I was afraid they would have been the "fallen off the truck" variety.

    [Speaking of apple, I just noticed my computer automatically capitalizes the P in iPad - a little built in self promo there!]

  7. Oh my goodness, Michele! I love learning about cultural differences. Yes, perhaps baby Bear was aspiring to be Thai :)

  8. Krlr, we actually ordered our through Apple. Andrew took care of it for me so I have no idea how he found it on their site. My computer also autocorrects to iPad.


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